Chapter 19 Intraoperative Nursing Management

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Chapter 19  Intraoperative Nursing Management

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

Multiple Choice

1. The nursing student is preparing an elderly patient for surgery. The patient is scheduled for a general anesthetic. Which side effect should the nurse monitor the patient for?
A) Hypothermia
B) Pulmonary edema

C) Cerebral ischemia
D) Increased ability to resist stress

Ans: A
Chapter: 19
Client Needs: D-3
Cognitive Level: Application
Difficulty: Difficult
Integrated Process: Nursing Process
Objective: 5
Page and Header: 455, Potential Intraoperative Complications

Feedback: Inadvertent hypothermia may occur as a result of a low temperature in the OR, infusion of cold fluids, inhalation of cold gases, open body wounds or cavities, decreased muscle activity, advanced age, or the pharmaceutical agents used (eg, vasodilators, phenothiazines, general anesthetics). The anesthetist monitors for pulmonary edema and cerebral ischemia. The

increased ability to resist stress is not monitored.

2. You are the circulating nurse. Which task are you solely responsible for? A) Monitoring the patient and documents
B) Estimating the patient’s blood loss
C) Setting up the sterile tables

D) Keeping track of drains and sponges

Ans: A
Chapter: 19
Client Needs: A-1
Cognitive Level: Comprehension Difficulty: Moderate
Integrated Process: Nursing Process Objective: 3
Page and Header: 444, The Surgical Team

Feedback: Main responsibilities include verifying consent; coordinating the team; and ensuring cleanliness, proper temperature, humidity, lighting, safe function of equipment, and the availability of supplies and materials. The circulating nurse monitors aseptic practices to avoid breaks in technique while coordinating the movement of related personnel (medical, x-ray, and laboratory), as well as implementing fire safety precautions. The circulating nurse also monitors the patient and documents specific activities throughout the operation to ensure the patient’s safety and well-being. Estimating the patient’s blood loss is the surgeon’s responsibility, setting up the sterile tables is the responsibility of the first scrub, and keeping track of the drains and sponges is the joint responsibility of the circulating nurse and the scrub.

3. A 21-year-old patient is positioned on the OR bed prior to knee surgery. The anesthesiologist administers the anesthetic. What is the next step in the care of this patient?
A) Grounding
B) Hanging IV fluids

C) Giving blood D) Intubating

Ans: D
Chapter: 19
Client Needs: D-3
Cognitive Level: Application Difficulty: Moderate
Integrated Process: Nursing Process

Objective: 3
Page and Header: 446, The Surgical Team

Feedback: When the patient arrives in the OR, the anesthesiologist or anesthetist reassesses the patient’s physical condition immediately prior to initiating anesthesia. The anesthetic is administered, and the patient’s airway is maintained through an intranasal intubation, oral intubation, or a laryngeal mask airway. This makes options A, B, and C incorrect.

4. You are the circulating nurse in an operating room that has several surgeries scheduled. You would know to monitor which patient during the intraoperative period because he or she is at increased risk for hypothermia?
A) A 72-year-old woman

B) A 17-year-old boy
C) A 45-year-old woman D) A 12-year-old girl

Ans: A
Chapter: 19
Client Needs: D-3
Cognitive Level: Application
Difficulty: Difficult
Integrated Process: Nursing Process Objective: 5
Page and Header: 443, The Surgical Team

Feedback: Elderly patients are at greatest risk during surgical procedures because they have an impaired ability to increase their metabolic rate and impaired thermoregulatory mechanisms, which increase susceptibility to hypothermia. This makes options B, C, and D incorrect.

5. The anesthetist is coming to the unit to see a patient prior to surgery that is scheduled for tomorrow morning. What information, obtained during the admission assessment, should be given to the anesthetist during the visit?
A) Last bowel movement

B) Latex allergy
C) Number of pregnancies D) Difficulty falling asleep

Ans: B
Chapter: 19 Client Needs: A-2

Cognitive Level: Application Difficulty: Moderate
Integrated Process: Nursing Process Objective: 2

Page and Header: 457, Potential Intraoperative Complications

Feedback: Due to the increased number of patients with latex allergies, it is essential to identify the allergy early on so precautions can be taken in the operating room. The anesthetist should be informed of any allergies.

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